MEDICARE: BAY AREA CHIROPRACTIC CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301006945	MI

General Provider Information

NPI Number	:	1235452657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA CHIROPRACTIC CENTER, INC

Provider Business Mailing Address
First Line	:	3895 N EUCLID AVE
Second Line	:	SUITE B
City	:	BAY CITY
State	:	MI
Zip	:	48706-2069
Country	:	US
Telephone Number	:	989-893-0631
Fax Number	:

Provider Business Practice Location Address
First Line	:	3895 N EUCLID AVE
Second Line	:	SUITE B
City	:	BAY CITY
State	:	MI
Zip	:	48706-2069
Country	:	US
Telephone Number	:	989-893-0631
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL JAY KAYNER
Credential	:	D.C.
Telephone Number	:	989-893-0631

Provider Enumeration Date	:	03/12/2010
Last Update Date	:	04/07/2011

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